Korean J Fam Pract 2019; 9(1): 10-16  https://doi.org/10.21215/kjfp.2019.9.1.10
Use of Haloperidol and Lorazepam for Intractable Symptoms in the Hospice Palliative Care Unit
Wook Namkoong, Jungmin Kim, Hyunseon Eo, Eunjin Chung, Junga Kim, Soohyoung Lee, Kihyon Park*
Department of Family Medicine, Seoul Medical Center, Seoul, Korea
Kihyon Park, Tel: +82-2-2276-8513, Fax: +82-2-2276-7377, E-mail: knuck0@seoulmc.or.kr, ORCID: http://orcid.org/0000-0003-4374-3886
Received: March 13, 2018; Revised: October 2, 2018; Accepted: October 17, 2018; Published online: February 20, 2019.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Terminally ill cancer patients suffer from refractory symptoms, and the last option of treatment is to consider sedatives. However, due to concerns that sedation may shorten survival time, some people prefer not to take sedatives. The purpose of this study was to investigate the effects of sedative administration on survival time among terminally ill cancer patients.
Methods: Two hundreds and thirty-seven patients who were hospitalized to the hospice care unit of public hospitals in Seoul from January, 2015 to March, 2016 were analyzed retrospectively. The univariate and multivariate Cox’s proportional hazard regression model was used to determine independent factors related to survival time.
Results: The usage of sedation was necessary because the incidence of insomnia was 61.4% in the lorazepam only group, and the incidence of delirium was highest in the haloperidol group and the haloperidol with lorazepam group. Interestingly, multivariate analysis showed that male (HR, 1.766; P <0.001), decreased consciousness (HR, 1.803; P=0.003), anorexia (HR, 1.506; P=0.012), resting dyspnea (HR, 1.757; P<0.001), elevated serum bilirubin (HR, 1.657; P=0.001), and the haloperidol with lorazepam group (HR, 0.535, P<0.001) were each significantly associated with survival time. Furthermore, patients in the haloperidol with lorazepam group survived longer than patients with no such medications.
Conclusion: There is no evidence that treatment with sedative medication shortens the survival time of patients with terminally ill cancer with refractory symptoms.
Keywords: Palliative Care; Terminal Cancer; Sedatives; Haloperidol; Lorazepam
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